Elevated eosinophil counts can indicate eosinophilic disorders, which can be caused by allergies, parasites, tumors, and cancers. Eosinophilic disorders can affect various areas of the body, including the esophagus, gastrointestinal tract, and skin. The causes and long-term prognoses of these disorders are still being studied.
The term “eosinophilic” is an adjective used to describe a broad range of disorders characterized by high eosinophil counts. Eosinophils are a type of white blood cell used to help fight certain infections and health problems, including allergies and parasites. In some patients, the eosinophil count is higher than it should be for no apparent cause. This usually indicates an eosinophilic disorder or eosinophilia. Eosinophilia is defined as the state of having more than 500 eosinophils per cubic millimeter of peripheral blood.
There are several causes for elevated eosinophils. Food and environmental allergies are very common causes of high eosinophils. Asthma, allergic rhinitis, atopic dermatitis, drug reactions, milk protein allergy, and urticaria are commonly associated with elevated eosinophil counts. Infections caused by some tissue invasive parasites also contribute to high levels. Tumors and some cancers can also explain eosinophilia.
Outside of a coexisting disease or disorder, some disorders are characterized by high numbers of eosinophils in certain areas of the body. For example, eosinophilic esophagitis (EE) is an allergic inflammation in the esophagus associated with high eosinophil counts in the area. Eosinophils persist despite acid-blocking drugs and other standard treatments for esophagitis. Patients with EE can actually suffer tissue injury in their esophagus from the buildup of eosinophils. Food allergy or intolerance could be a cause of EE, and eliminating dietary protein from the diet of EE patients has shown to be a promising treatment.
Similarly, eosinophilic gastroenteritis (EGE) is a rare and chronic disease characterized by the accumulation of eosinophils in the gastrointestinal tract presenting with many unpleasant symptoms. Pain, cramping, vomiting, diarrhea, and blockages make this ailment difficult for sufferers. Symptoms tend to wax and wane over time, and with proper diet and treatment, the promise of a remission is promising. Pediatric patients with EGE may have relative failure to thrive, growth retardation, amenorrhea, or delayed puberty.
Eosinophilic fasciitis, also known as Shulman syndrome, is another eosinophilic disease. Shulman syndrome is a skin disorder in which the skin and underlying fascia become inflamed and thickened, sometimes in addition to warmth, redness, and hardening of the skin surface. This disorder sometimes follows a period of high physical exertion, but it can also be associated with some types of cancer.
These and other eosinophilic disorders appear to be more prevalent in males and in Caucasians and Asians. The exact causes and long-term prognoses have been the subject of study and debate. There has been an increase in diagnoses of the disorders, but whether this is the result of an increase in incidence or better diagnostic practices has been questioned.
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